Tazewell County CPMT debates use of emergency email polls for CSA approvals

Tazewell County CPMT Chair Lori Gates-Addison raised concerns Dec. 19 that the team is increasingly using email polls to approve services described as "emergencies," asking whether some approvals should wait for regular in-person meetings.

Gates-Addison said members should prioritize in-person approvals and questioned whether short-notice counseling authorizations—such as a counseling start for a stepfather—constitute emergencies deserving an email poll. She asked about billing implications and whether providers accept primary insurance.

The CSA coordinator told the team email polls are used when services must begin before the next scheduled CPMT meeting and gave a specific example of a worker requesting Family Preservation Services (FPS) begin counseling Dec. 12 to support reunification. The coordinator said holding more frequent FAPT or CPMT meetings would reduce but not eliminate the need for polls when unexpected placement interruptions occur.

To support the practice, the coordinator provided excerpts from the Tazewell County CSA Local Policy and Procedure Manual describing emergency funding requests and the email-poll process and read an August 2014 email between then-CSA coordinator Sharon Puckett and OCS Program Consultant Brady Nemeyer. According to the packet read at the meeting, Nemeyer replied, "Yes, your CPMT can adopt a policy that allows email polls between CPMT meetings," and laid out information the CPMT should include when conducting such polls.

The coordinator also supplied an audit of email polls from August through December 2022 showing the number and reasons for polls each month (examples included emergency placements, counseling pending residential acceptance, daycare when foster parents work, utilities to prevent termination, and service gaps from worker transitions). The counts provided were: 10 email polls in August, 2 in September, 6 in October, 3 in November and 5 in December.

Chair Gates-Addison asked whether Family Preservation Services accepts Medicare; Dwayne Sturgill replied FPS does not take Medicare, and the coordinator noted that where the stepfather had Medicare as primary and Medicaid secondary, Medicaid could not be billed until the primary insurer was billed. That billing constraint was cited as part of the reason staff sought an email poll to begin services sooner.

The CPMT did not take a formal vote to change its policy during the meeting; members reviewed the documentation and raised no additional comment after the packet was presented. The discussion concluded with the coordinator's documentation left in the packet for further review.

The CPMT plans to continue addressing operational questions about emergency email polls and insurance/billing constraints at future meetings, and members were given the relevant policy pages and correspondence for reference.